Coronary Artery Disease: Helping a Loved One

Topic Overview

How can I help a loved one who has coronary artery disease?

If you have a family member or other loved
one who has
coronary artery disease (CAD) or has just returned
home from the hospital due to a complication of CAD, you may want to know what
you can do to help. Your loved one may be able to do fewer normal
activities and may also need a great deal of encouragement and emotional
support. This article provides some guidelines on helping with daily activities
and offering emotional support to loved ones who are recovering from
CAD-related hospitalization.

What if CAD turns into end-stage heart failure?

Your loved one may need
special assistance if CAD leads to
heart failure. Heart failure typically results in a
weakened heart, one that cannot pump blood in sufficient quantities to the
body. Often, people with end-stage heart failure are not able to perform all
the tasks and activities that they did in the past with ease. And they may rely
on you for both emotional support and physical assistance. As you read this
article, you may want to think about how you may help a loved one in either
situation: recovery from a CAD-related hospital stay or the later stages of
heart failure.

How can I help with daily activities?

People who have CAD may have a lot of
physical limitations because of angina symptoms or shortness of breath with exertion
or because of severe weakness. These people may rely on others for
help with relatively simple but important tasks. If your loved one experiences
trouble with daily activities, you and your family may choose to assume a large
role in managing his or her day-to-day life. Some of the ways in which you can
help are listed below.

Shopping for and preparing food. Most people recovering from surgery cannot leave their house on
their own to shop for food and therefore depend on others for what they eat. If
you can, ask neighbors and friends to help with grocery shopping. Also, you may
be closely involved in the preparation of heart-healthy food for
your loved one during recovery at home.

Providing a clean environment. Cleaning the house may be too difficult during
recovery. But a clean environment can be important for both mood and
health (to prevent infections). Caregivers should consider cleaning the house
regularly or hiring a maid service. Also, the temperature and humidity
of the home should be controlled as precisely as possible. The physical
discomforts of recovery from surgery often get worse during hot, humid days, and
air conditioners should be used during the summer, if
possible.

Driving. For the first 3 to 6
weeks after surgery, or if your loved one can no longer drive because of chest
pain or pressure, irregular heartbeats, fainting spells, or other complications of
CAD-related heart failure, you may need to drive him or her to frequent doctor
appointments.

Medicines. Most people with
severe heart disease require multiple medicines to control their symptoms.
Having a family member organize medicines into a special pillbox with one or
more compartments for each day of the week can prevent the person from
forgetting to take any medicines or taking them incorrectly.

How can I provide emotional support?

Being a full-time caregiver may be an unfamiliar
role for you and one in which you never imagined yourself. There are several
things you can do to help provide the emotional support that your loved one
needs at this time:

Offer encouragement.
Adopting lifestyle changes recommended for people with heart disease can be
difficult. If the person you are caring for cannot comply with a strict diet or
exercise regimen, encourage him or her to start slowly and build up to the
ultimate goal over time. You may also offer to alter your own diet or lifestyle
to encourage healthy behaviors. This is particularly true for smoking, since it
can be nearly impossible for an individual to quit smoking if there is another
smoker in the home.

Help. Offer help, but
encourage your loved one to remain active. Even though people who have just
been hospitalized have physical limitations, they should still try to stay
active as long as this does not cause undue strain. Getting moderate exercise
and completing tasks around the house can often be done safely and will help
the person you are looking after feel better both physically and mentally. If
you are concerned about what level of activity is appropriate, speak with the
doctor who has been the most involved in your loved one's
care.

Ask if you can participate in doctor visits. Offer support by sitting in on doctor visits and taking notes. Your
loved one will be better able to remember important instructions if you help
keep a record.

Be realistic about the future. Your loved one may be facing a serious situation. You can help prepare
for the future by helping review insurance policies, wills, and
finances.

Respect the wishes of the person you are caring for. Discuss living wills and other advance directives, and be
clear about wishes concerning artificial life support in case you should be
called upon later to make this important decision.

Why is it important to also look after myself?

Looking after a loved one who has CAD can be
mentally and physically challenging, especially in the end stages of the
disease. There are steps you can take to help make the situation more
manageable for yourself. Remember that you will be an effective and loving
caregiver only if your own physical health and mental outlook remain
good.

Enlist help when you need it. If possible,
involve other family members or enlist the help of a visiting nurse. You may
also hire a food delivery or housekeeping service to help with cooking and
cleaning.

Take time for yourself. Offering care can be stressful
and time-consuming. To make sure that you do not burn out and that you can
continue to provide love and care, it is very important to make time for
activities you enjoy.

Seek emotional support if you need to.
Caring for a loved one who is recovering from a major procedure and who has a
chronic disease can be emotionally difficult.

If you are having difficulty coping with your feelings, you
should not feel ashamed or embarrassed about seeking advice and counseling from
appropriate sources, such as other family members, trained mental health
professionals, or religious advisers. Look for peer groups. You may be able to
find support groups for people with caregiving responsibilities. Talking to
other people who are in similar situations may be a valuable way for you to
share your concerns and also to gather information.

When should I seek outside help?

Some families cannot assume care for a loved one who has severe heart disease
without enlisting outside help. Economic stresses may be overwhelming and, if
all the family members are at work, adequate at-home supervision and care for
the patient may not be possible. Also, some people require more care than their family can be reasonably expected to provide. In
these cases, you may consider placing your loved one in a long-term care
facility.

The available long-term care options depend on an
individual's level of independence and need for nursing supervision. Some
people will still be able to do basic activities on their own but may need
assistance preparing meals and sorting medicines. Such individuals may be
well cared for in a supervised living facility where food is provided and staff
is available to assist them, if needed, but where routine nursing care is not
provided.

Other people with severe heart disease may have
difficulty performing basic activities and may be better served in a nursing
home where the staff can assist them with eating and bathing. In these more
closely monitored settings, nurses can track your loved one's symptoms and ensure that he or she takes medicines appropriately.

It is important for people in these facilities to feel that they are
still a part of their family. Frequent visits by family members or day trips to
the family home help a lot to improve the loved ones' emotional health.

At first,
you may think that paying for this care will be prohibitively expensive.
But there may be options available to make the cost more manageable.

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